Constipation and Diarrhoea in Young Children

Changes in your child's nappies or bowel habits can be confusing and sometimes alarming. I have created this video to help you understand what is normal; what is not; and where to seek help quickly if needed. Children's bowel patterns vary widely, and what is normal for one child may not be normal for another. Some children pass stools several times a day, while others go every two or three days, and both can be perfectly healthy. Constipation is very common in young children. The NHS reports that it affects around one in three children at some point during early childhood. Signs of constipation include: fewer than three stools a week; stools that are large, hard, or painful to pass; and a child who is regularly straining on the toilet. Some children hold back stools because of pain, and this can make the problem worse over time. Common triggers include changes in diet, dehydration, starting nursery or school, or anxiety around toilet training. Sometimes there is no obvious cause, and that is also common. If your child is over one year old, leaking soft or runny stool into pants can also signal constipation. This is called overflow soiling and often surprises families, as it can look like diarrhoea. NHS guidance recommends treating childhood constipation early with a careful plan, often including a laxative called a macrogol. Diet and fluids matter too, but they are part of long-term bowel health rather than a treatment on their own. Diarrhoea is the other side of the same coin, and is also common in early childhood. The usual cause is a viral tummy bug - which typically settles within five to seven days at home. Most children with mild gastroenteritis recover well with small frequent sips of water; breast milk; or oral rehydration solution. Anti-diarrhoea medicines are not recommended for children; as the gut clears infection more safely on its own. Dehydration is the main concern with diarrhoea, especially in younger children and babies. Look for fewer wet nappies, a dry mouth, sunken eyes, drowsiness - or a baby who is less alert and harder to rouse than usual. Some signs always need urgent medical attention. These include blood in the stool, green vomit, signs of dehydration, a high temperature in a baby under three months, or a child who seems very unwell or hard to rouse. A specialist review is helpful when symptoms persist beyond two weeks; when growth is slowing; or when you remain unsure of the cause. Trust your instinct; and please do not feel you need to wait until things feel serious. As a consultant paediatrician, I assess each child carefully, exclude underlying causes, and agree a clear and practical plan with you. Useful information is also available from ERIC, the UK charity for children's bowel and bladder health. Please contact me anytime if you have further questions or need help with your child's care.